Livingstone — Although largely unnoticed in the developed world, malaria strikes
500 million people a year and kills nearly a million children younger than
five, mostly in sub-Saharan Africa. Treating the disease absorbs a
significant amount of income in poor households, and the economic and social
effects of chronic infections are a major obstacle in Africa's progress
towards the UN Millennium Development Goal of reducing severe poverty.

In May this year, the Bill and Melinda Gates Foundation announced a
$35 million grant to PATH, a U.S.-based non-profit organization, to develop
and demonstrate strategies that can successfully curb malaria's spread. The
result is the Malaria Control and Evaluation Partnership in Africa (Macepa),
which is funding an in-country collaboration among PATH, the government of
Zambia, and the Zambia Roll Back Malaria Partnership. The project is
supporting "the coordination of a rapid implementation of proven
malaria-control strategies - including insecticide-treated bed nets, indoor
mosquito control, and effective medication."

Directing Macepa is a veteran malaria fighter, Dr. Carlos (Kent)
Campbell, a former head of the Malaria Branch at the U.S. Centers for
Disease Control, who says the support of the Gates Foundation has
transformed the global approach to deadly diseases. The foundation's
strategy is "breathtaking," he says, giving public health officials an
unprecedented freedom to think new thoughts, build new alliances and achieve
new successes.

AllAfrica's Margaret McElligott has taken a close-up look at
Macepa's early efforts.

Zambia's national malaria control program is rolling ahead with massive
anti-malarial interventions, including indoor residual spraying,
artemisinin-based combination therapies (ACT) in government health clinics
and more than 500,000 insecticide-treated bed nets and 500,000 retreatment
kits.

The coordinated response is part of the Malaria Evaluation and Control
Project in Africa (Macepa), recently launched with the aim of reaching 80
percent of the population and reducing malaria-related deaths by 75 percent
within three years in the first battleground country, Zambia. Its success
will serve as a model for other African nations.

The distribution of bed nets in health clinics and homes began before
last week's symbolic handover ceremony from PATH and the Bill and Melinda
Gates Foundation to Zambia's Ministry of Health. Officials from PATH, a
U.S.-based non-governmental organization working to improve health
technology in developing countries, said the speed of the bed net rollout
shows the partnership's commitment to fighting malaria. They said the
introduction of new technologies has made malaria a preventable and
treatable disease.

"Malaria remains the number one killer in Zambia and as such, the
Ministry of Health has worked to control and eradicate it," said Chilufya
Kazenene, Zambia's deputy minister of health.

At least 40 percent of Zambia's childhood deaths are caused by malaria,
according to the Zambia Malaria Foundation, and the parasite is a huge
burden to the country's productivity and agricultural development. Average
households in Zambia experience 2.4 cases of malaria each year.

Kazanene said that government is providing direction for all
anti-malaria activities undertaken by partners.

"The national strategic plan will provide the framework to scale-up
efforts," he said at the handover ceremony.

Development partners, especially the Gates Foundation-funded PATH, said
cooperation on the national plan is unique because of the leadership role
taken by government in developing the national strategy. Instead of each
organization funding their own priorities, donor agencies are cooperating to
achieve the goals set by the Ministry of Health's national malaria control
plan, said Dr. Kent Campbell, program director at PATH.

Campbell said that PATH and the Gates Foundation hope to demonstrate
that malaria can be eliminated in Zambia, which can then be used as a model
for anti-malaria efforts elsewhere in Africa. Large investments by the
Zambian government, the Gates Foundation, the World Bank, the Global Fund to
Fight Aids, Malaria and Tuberculosis have combined so that the national
effort can tackle malaria prevention and treatment comprehensively across
the country, he said. Campbell said the Global Fund provides crucial
partnership and influence on the African continent because it has given
governments the resources to negotiate with and exert control over other
donors, as well as the confidence to get into dialogue with partners.

"There's a strong political agenda here," Campbell said about his desire
to publicize the work of the anti-malaria partnership. "This has to be a
national story. It has to have a national voice and a national face to it."

Between 2003 and 2004, Zambia recorded a drop in deaths due to malaria
from 50,000 to 30,000, and officials hope the aggressive malaria control
strategy will result in even fewer deaths this year. Part of the decline is
due to the government's decision to use ACT for treatment in all government
health clinics, a move Campbell said was bold considering the high cost of
the drug, but the "right thing to do."

Zambian health officials say they appreciate the role played by PATH and
the Gates Foundation in following the government's lead on malaria.

"This is a new partner that has come on the floor with so much steam and
so much enthusiasm to work with as a partner," said Dr. Naawa Sipilanyambe,
acting coordinator of the National Malaria Control Center. "We are moving
in the right direction. Let us continue working together."

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